Doing Nothing: The Ceremony of Innocence

Hospital administrators are part of a very small group of infallible indicators of future behavior. They are always wrong. Thus if you want to know what to do, ask a hospital administrator and then do precisely the opposite. You will never be wrong. Of course hospital administrators are not hired to be wrong, they are expected to be right. When experience, usually long and repetitious, proves their plans inapposite they are fired and a search begun with high hopes for an administrator who will get the ship going in the right direction. This of course is wasteful and unnecessary, any hospital administrator will do if one remembers their perfect ability to chart the correct course minus 180^o.

This year the chart problem, which had always resolved itself completely by the summer solstice, which was convenient since the house staff year ended on the 30th of June, was treated with the same vigor and effectiveness as a cancer. The interns all developed global amnesia, which they said made it impossible for them to dictate any charts since their memory of the patients' hospital course and recommended disposition had fled from their minds irretrievably. Mr Riley wanted to fire them for malingering but was reminded by his assistant hospital administrator, who had not yet achieved infallibility, that he couldn't run the hospital without them and by his counsel who averred that doing so would expose the hospital to liability if the house officers brought a class action against the hospital. There was a rule against firing any group of employees registered to vote in the city of New York numbering more than 100. Of course, the counsel continued, the interns weren't receiving the salary that had been appropriated for them. Therefore the court might rule that they lacked standing. On the other hand the District Attorney who was up for reelection might view the failure to pay them as misprision with considerable ill effect to the hospital and its administrator. Furthermore the Daily News might put the story on the front page. The paper also might put the hospital on the front page for ignoring the intolerable conditions which the undictated charts had created. In addition the Federal Trade Commission might bring administrative action against the hospital for its failure to pay the interns the minimum wage. The administrator was also warned that the Internal Revenue Service might rule that the hospital had a sizable tax liability despite its tax exempt status if it did pay the interns while the Medical School was collecting tuition. The counsel advised that the administrator take all this into account before making any decision. Failure to act would doubtless have dire consequences, while acting carried considerable risk. Well advised, Mr Riley concluded that his only viable option was to proceed as he had threatened on his proclamation.